The Public Health Approach to Preventing Sexual Violence

  • Ryan T. ShieldsEmail author
  • Kenneth A. Feder


Sexual violence remains a significant global public health problem. Experiences with sexual violence confer greater risk for physical, mental, and behavioral health problems, and this trauma can impact individuals, families, and communities in a variety of ways. Despite the recognition of sexual violence as a public health problem, the dominant response rests within a criminal justice framework, one that typically focuses on the incapacitation and management of known offenders. This, in our view, is a limited approach. Indeed, research has not demonstrated that criminal justice sex crime policies are effective in reducing sexual violence, and this literature also suggests that these policies may in fact contribute to harm to both victims and perpetrators. In contrast to this criminal justice focus, this chapter argues for advancing a public health perspective for the primary prevention of sexual violence. To that end, this chapter will discuss how a public health approach to violence prevention can inform our understanding of sexual violence and the ways to reduce sexual victimization. Particular emphasis will be placed on understanding the social ecological model that frames sexual violence as a phenomenon affected not only by individual factors, but also by relationship factors, community norms, and social values. This chapter closes with recommendations for future work in the prevention of sexual violence.


Sexual violence Child sexual abuse Public health Prevention Social ecological model 


  1. Ackerman, A. R., Sacks, M., & Greenberg, D. F. (2012). Legislation targeting sex offenders: Are recent policies effective in reducing rape? Justice Quarterly, 29, 858–887.Google Scholar
  2. Banyard, V. L. (2011). Who will help prevent sexual violence: Creating an ecological model of bystander intervention. Psychology of Violence, 1, 216–229.CrossRefGoogle Scholar
  3. Basile, K. C. (2003). Implications of public health for policy on sexual violence. Annals of the New York Academy of Sciences, 989, 446–463.ADSCrossRefPubMedGoogle Scholar
  4. Basile, K. C., & Smith, S. G. (2011). Sexual violence victimization of women: Prevalence, characteristics, and the role of public health and prevention. American Journal of Lifestyle Medicine (Online first).Google Scholar
  5. Batastini, A. B., Hunt, E., Present-Koller, J., & DeMatteo, D. (2011). Federal standards for community registration of juvenile sex offenders: An evaluation of risk prediction and future implications. Psychology, Public Policy, and Law, 17, 451–474.CrossRefGoogle Scholar
  6. Becker, J. V., & Reilly, D. W. (1999). Preventing sexual abuse and assault. Sexual Abuse: A Journal of Research and Treatment, 11(4), 267–278.Google Scholar
  7. Bedi, S., Nelson, E. C., Lynskey, M. T., McCutcheon, V. V., Heath, A. C., Madden, P. A. F., et al. (2011). Risk for suicidal thoughts and behavior after childhood sexual abuse in women and men. Suicide and Life-Threatening Behavior, 41(4), 406–415.CrossRefPubMedPubMedCentralGoogle Scholar
  8. Berliner, L. (2011). Child sexual abuse: Definitions, prevalence, and consequences. In J. E. B. Myers (Ed.), The APSAC handbook on child maltreatment (3rd ed., pp. 215–232). Thousand Oaks, CA: SAGE.Google Scholar
  9. Black, M., Basile, K., Breiding, M., Smith, S., Walters, M., Merrick, M., et al. (2011). The national intimate partner and sexual violence survey: 2010 summary report. Atlanta, Georgia: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.Google Scholar
  10. Butchart, A., Harvey, A. P., Mian, M., & Furniss, T. (2006). Preventing child maltreatment: A guide to taking action and generating evidence. World Health Organization.Google Scholar
  11. Caldwell, M. F. (2010). Study characteristics and recidivism base rates in juvenile sex offender recidivism. International Journal of Offender Therapy and Comparative Criminology, 54(2), 197–212.CrossRefPubMedGoogle Scholar
  12. Caldwell, M. F., Ziemke, M. H., & Vitacco, M. J. (2008). An examination of the sex offender registration and notification act as applied to juveniles: Evaluating the ability to predict sexual recidivism. Psychology, Public policy, and Law, 14, 89–114.CrossRefGoogle Scholar
  13. Campbell, J., & Soeken, K. (1999). Forced sex and intimate partner violence: Effects on women’s risk and women’s health. Violence Against Women, 5(9), 1017–1035.CrossRefGoogle Scholar
  14. Carpentier, M. Y., Silovsky, J. F., & Chaffin, M. (2006). Randomized trial of treatment for children with sexual behavior problems: Ten-year follow-up. Journal of Consulting and Clinical Psychology, 74, 482–488.CrossRefPubMedGoogle Scholar
  15. CDC. (2015). The social-ecological model: A framework for prevention. Last updated March, 2015. Retrieved from
  16. Chaffin, M. (2008). Our minds are made up—don’t confuse us with the facts: Commentary on policies concerning children with sexual behavior problems and juvenile sex offenders. Child Maltreatment, 13, 110–121.CrossRefPubMedGoogle Scholar
  17. Collett, B. J., Cordle, C. J., Stewart, C. R., & Jagger, C. (1998). A comparative study of women with chronic pelvic pain, chronic non-pelvic pain. British Journal of Obstetrics and Gynecology, 105, 87–92.CrossRefGoogle Scholar
  18. Comartin, E. B., Kernsmith, P. D., & Miles, B. W. (2010). Family experiences of young adult sex offender registration. Journal of Child Sexual Abuse, 19, 204–225.CrossRefPubMedGoogle Scholar
  19. Creamer, M., Burgess, P., & McFarlane, M. C. (2001). Post-traumatic stress disorder: Findings from the Australian national survey of mental health and well-being. Psychological Medicine, 7, 1237–1247.Google Scholar
  20. Dahlberg, L. L., & Mercy, J. A. (2009). History of violence as a public health problem. Virtual Mentor, 11, 167–172.CrossRefPubMedGoogle Scholar
  21. Darves-Bornoz, J. M. (1997). Rape-related psychotraumatic syndromes. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 71(1), 59–65.CrossRefPubMedGoogle Scholar
  22. DeLisi, M., Kosloski, A. E., Vaughn, M. G., Caudill, J. W., & Trulson, C. R. (2014). Does childhood sexual abuse victimization translate into juvenile sexual offending? New evidence. Violence and victims, 29(4), 620–635.Google Scholar
  23. Dong, M., Giles, W. H., Felittie, V. J., Dube, S. R., & Anda, R. F. (2004). Insights into causal pathways for ischemic heart disease: Adverse childhood experiences study. Circulation, 110, 1761–1766.CrossRefPubMedGoogle Scholar
  24. Dorfman, L., Mejia, P., Cheyne, A., & Gonzalez, P. (2011). Case by case: New coverage of child sexual abuse. Berkley Media Studies Group. Retrieved from
  25. Dorfman, L., Mejia, P., Gonzalez, P., & Cheyne, A. (2012). Breaking news on child sexual abuse: Early coverage of Penn State. Berkley Media Studies Group. Retrieved from
  26. Du Mont, J., Miller, K. L., & Myhr, T. (2003). The role of ‘real rape’ and ‘real victim’ stereotypes in the police reporting practices of sexually assaulted women. Violence Against Women, 9, 466–486.CrossRefGoogle Scholar
  27. Finkelhor, D. (1994). Current information on the scope and nature of childhood sexual abuse. The Future of Children, VS75, pp. 35–53.Google Scholar
  28. Finkelhor, D., Asdigian, N., & Dziuba-Leatherman, J. (1995). Victimization prevention programs for children: A follow-up. American Journal of Public Health, 85, 1684–1689.CrossRefPubMedPubMedCentralGoogle Scholar
  29. Finkelhor, D., Ormrod, R., & Chaffin, M. (2009). Juveniles who commit sex offenses against minors. In Juvenile justice bulletin. Washington, DC: Office of Juvenile Justice and Delinquency Prevention.Google Scholar
  30. Finkelhor, D., Ormord, R., Turner, H., & Hamby, S. L. (2005). The victimization of children and youth: A comprehensive, national survey. Child Maltreatment, 10, 5–25.CrossRefPubMedGoogle Scholar
  31. Finkelhor, D., Vanderminden, J., Turner, H., Shattuck, A., & Hamby, S. (2014). Youth exposure to violence prevention programs in a national sample. Child Abuse and Neglect, 38, 677–686.CrossRefPubMedGoogle Scholar
  32. Fisher, B., Cullen, F., & Turner, M. (2000). The sexual victimization of college women. Bureau of Justice Statistics, Office of Justice Programs, U.S. Department of Justice, NCJ 182369.Google Scholar
  33. Greenfeld, L. (1997). Sex offenses and offenders: An analysis of data on rape and sexual assault. Bureau of Justice Statistics, Office of Justice Programs, U.S. Department of Justice, NCJ 163392.Google Scholar
  34. Hammond, W. R., Whitaker, D. J., Lutzker, J. R., Mercy, J., & Chin, P. M. (2006). Setting a violence prevention agenda at the centers for disease control and prevention. Aggression and Violent Behavior, 11, 112–119.CrossRefGoogle Scholar
  35. Harris, A. J., Walfield, S. M., Shields, R. T., & Letourneau, E. J. (2015). Collateral consequences of juvenile sex offender registration and notification: Results from a survey of treatment providers. Sexual abuse: A Journal of Research and Treatment (Online first).Google Scholar
  36. Holmes, M., Resnick, H., Kilpatrick, D., & Best, C. (1996). Rape related pregnancy: Estimates and descriptive characteristics from a national sample of women. American Journal of Obstetrics and Gynecology, 175(2), 370–375.CrossRefGoogle Scholar
  37. Gross, A., Winslet, A., Roberts, M., & Gohm, C. (2006). An examination of sexual violence against college women. Violence Against Women, 12(3), 288–300.CrossRefPubMedGoogle Scholar
  38. Krug, E., Dahlberg, L., Mercy, J., Zwi, A., & Lozano, R. (2002). World report on violence and health. Geneva: World Health Organization.Google Scholar
  39. Lanning, K. (2010). Child molesters: A behavioral analysis. National Center for Missing and Exploited Children.Google Scholar
  40. Letourneau, E. J., Armstrong, K. S., Bandyopadhyay, D., & Sinha, D. (2013). Sex offender registration and notification policy increases juvenile plea bargains. Sexual Abuse: A Journal of Research and Treatment, 25, 189–207.CrossRefGoogle Scholar
  41. Letourneau, E. J., Bandyopadhyay, D., Armstrong, K. S., & Sinha, D. (2010). do sex offender registration and notification requirements deter juvenile sex crimes? Criminal Justice and Behavior, 37, 553–569.Google Scholar
  42. Letourneau, E. J., Bandyopadhyay, D., Sinha, D., & Armstrong, K. S. (2009a). The influence of sex offender registration on juvenile sexual recidivism. Criminal Justice Policy Review, 20, 136–153.CrossRefGoogle Scholar
  43. Letourneau, E. J., Bandyopadhyay, D., Sinha, D., & Armstrong, K. S. (2009b). The effects of sex offender registration policies on juvenile justice decision making. Sexual Abuse: A Journal of Research and Treatment, 21, 149–165.Google Scholar
  44. Letourneau, E. J., Eaton, W. W., Bass, J., Berlin, F. S., & Moore, S. G. (2014). The need for a comprehensive public health approach to preventing child sexual abuse. Public Health Reports, 129(3), 222.PubMedPubMedCentralGoogle Scholar
  45. Letourneau, E. J., Henggeler, S. W., Borduin, C. M., Schewe, P. A., McCart, M. R., Chapman, J. E., et al. (2009c). Multisystemic therapy for juvenile sexual offenders: 1-year results from a randomized effectiveness trial. Journal of Family Psychology, 23(1), 89–102.CrossRefPubMedPubMedCentralGoogle Scholar
  46. Levenson, J. (2009). Sex offender residence restrictions. In R. G. Wright (Ed.), Sex offender laws: Failed policies, new directions (pp. 267–290). New York: Springfield Publishing Company, Inc.Google Scholar
  47. Levenson, J. S., & Cotter, L. P. (2005). The effect of Megan’s Law on sex offender reintegration. Journal of Contemporary Criminal Justice, 21, 49–66.CrossRefGoogle Scholar
  48. Logan, W. A. (2009). Knowledge as power: Criminal registration and notification laws in America. Stanford, CA: Stanford Law Books.CrossRefGoogle Scholar
  49. Mancini, C. (2014). Sex crime, offenders, & society: A critical look at sexual offending and policy. Durham, NC: Carolina Academic Press.Google Scholar
  50. Mancini, C., Shields, R. T., Mears, D. P., & Beaver, K. M. (2010). Sex offender residence restriction laws: Parental perceptions and public policy. Journal of Criminal Justice, 38, 1022–1030.CrossRefGoogle Scholar
  51. McMahon, P. M. (2000). The public health approach to the prevention of sexual violence. Sexual Abuse: A Journal of Research and Treatment, 12, 27–36.Google Scholar
  52. Meloy, M. L., Miller, S. L., & Curtis, K. M. (2008). Making sense out of nonsense: The deconstruction of state-level sex offender residence restrictions. American Journal of Criminal Justice, 33, 209–222.CrossRefGoogle Scholar
  53. Mendelson, T., & Letourneau, E. J. (2015). Parent-focused prevention of child sexual abuse. Prevention Science, 16, 844–852.CrossRefPubMedGoogle Scholar
  54. Mercy, J. A., Rosenberg, M. L., Powell, K. E., Broome, C. V., & Roper, W. L. (1993). Public health policy for preventing violence. Health Affairs, 12, 7–29.CrossRefPubMedGoogle Scholar
  55. Messman-Moore, T. L., & Long, P. J. (2000). Child sexual abuse and revictimization in the form of adult sexual abuse, adult physical abuse, and adult psychological maltreatment. Journal of interpersonal violence, 15, 489–502.CrossRefGoogle Scholar
  56. Miller, M. (1999). A model to explain the relationship between sexual abuse and HIV risk among women. AIDS Care: Psychological and Socio-medical Aspects of HIV/AIDS, 11(1), 3–20.CrossRefGoogle Scholar
  57. Noll, J. G., Horowitz, L. A., Bonanno, G. A., Trickett, P. K., & Putnam, F. W. (2003). Revictimization and self-harm in females who experienced childhood sexual abuse: results from a prospective study. Journal of Interpersonal Violence, 18, 1452–1471.CrossRefPubMedGoogle Scholar
  58. Noll, J. G., Zeller, M. H., Trickett, P. K., & Putnam, F. W. (2007). Obesity risk for female victims of childhood sexual abuse: a prospective study. Pediatrics, 120, e61–e67.CrossRefPubMedGoogle Scholar
  59. Pereda, N., Guilera, G., Forns, M., & Gomez-Benito, J. (2009). The prevalence of child sexual abuse in community and student samples: A meta-analysis. Clinical Psychology Review, 29, 328–338.CrossRefPubMedGoogle Scholar
  60. Petrunik, M. (2003). The hare and the tortoise: Dangerousness and sex offender policy in the United States and Canada. Canadian Journal of Criminology and Criminal Justice, 45, 43–72.CrossRefGoogle Scholar
  61. Pittman, N. (2013). Raised on the registry: The irreparable harm of placing children on sex offender registries in the U.S. Washington, DC: Human Rights Watch. Retrieved from
  62. Pittman, N., & Nguyen, Q. (2011). A snapshot of juvenile sex offender registration and notification laws: A survey of the states. Philadelphia, PA: Defender Association of Philadelphia. Retrieved from
  63. Plummer, C. A. (2001). Prevention of child sexual abuse: A survey of 87 programs. Violence and Victims, 16, 575–588.PubMedGoogle Scholar
  64. Putnam, F. W. (2003). Ten-year research update review: Child sexual abuse. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 269–278.CrossRefPubMedGoogle Scholar
  65. Sample, L. L., & Evans, M. K. (2009). Sex offender registration and community notification. In R. G. Wright (Ed.), Sex offender laws: Failed policies, new directions (pp. 211–242). New York: Springfield Publishing Company, Inc.Google Scholar
  66. Sedlak, A., Mettenburg, J., Basena, M., Petta, I., McPherson, K., Greene, A., & Li, S. (2010). Fourth national incidence study of child abuse and neglect (NIS-4): Report to Congress. Office of Planning Research and Evaluation and the Children’s Bureau, Administration for Children and Families, U.S. Department of Health and Human Services. Retrieved from
  67. Sinovich, S. & Langhton, L. (2014). Rape and sexual assault victimization among college age females, 1995–2013. Bureau of justice statistics, Office of Justice Programs, U.S. Department of Justice, NCJ 248471.Google Scholar
  68. Snyder, H. N. (2000). Sexual assault of young children as reported to law enforcement: Victim, incident and offender characteristics. In A NIBRS statistical report. U.S. Department of Justice, Washington, D.C.Google Scholar
  69. Sommarin, C., Kilbane, T., Mercy, J. A., Maloney-Kitts, M., & Ligiero, D. P. (2014). Preventing sexual violence and HIV in children. Journal of Acquired Immune Deficiency Syndrome, 66, S217–S223.CrossRefGoogle Scholar
  70. Spohn, C. C. (2000). Thirty years of sentencing reform: The quest for a racially neutral sentencing process. Criminal Justice, 3, 427–501.Google Scholar
  71. Tabachnick, J. (2013). Why prevention? Why now? International Journal of Behavioral Consultation and Therapy, 8(3–4), 55.Google Scholar
  72. Taylor, B. G., Stein, N. D., Mumford, E. A., & Woods, D. (2013). Shifting Boundaries: an experimental evaluation of a dating violence prevention program in middle schools. Prevention Science, 14(1), 64–76.CrossRefPubMedGoogle Scholar
  73. Townsend, C., & Rheingold, A. A. (2011). Estimating a child sexual abuse prevalence rate for practitioners: A review of child sexual abuse prevalence studies. 2013; Retrieved from,
  74. Truman, K., & Langhton, L. (2015). Criminal victimization, 2014. NCJ: Bureau of Justice Statistics. 248973.Google Scholar
  75. WHO. (1999). Report of the consultation on child abuse prevention. Geneva: World Health Organization, 29–31 Mar 1999.Google Scholar
  76. WHO. (2013). Global and regional estimates of violence against women: Prevalence of health effects of intimate partner violence and non-partner sexual violence. Geneva: World Health Organization.Google Scholar
  77. Wurtele, S. K. (2009). Preventing sexual abuse of children in the twenty-first century: Preparing for challenges and opportunities. Journal of Child Sexual Abuse, 18, 1–18.CrossRefPubMedGoogle Scholar

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© Springer International Publishing AG 2016

Authors and Affiliations

  1. 1.Johns Hopkins UniversityBaltimoreUSA

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